Individual
CHRISTIE LYNN KELLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
T-LPC
Contact information
Practice address
809 S PATTON RD, GREAT BEND, KS 67530-4620
(620) 796-2206
(866) 288-1782
Mailing address
PO BOX 1223, GREAT BEND, KS 67530-1223
(620) 796-2206
(866) 288-1782
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
—
—
101YA0400X
Addiction (Substance Use Disorder) Counselor
703
KS
101YM0800X
Mental Health Counselor
—
—
101YP2500X
Professional Counselor
Primary
2755
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
201137740C
—
KS
Enumeration date
01/14/2016
Last updated
10/16/2019
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